This proposal represents a continuation and further development of of our existing NCMHD P60 Center of Excellence, the Columbia Center for the Health of Urban Minorities (CHUM). Building on the successful efforts of CHUM's first three years, we propose to develop CHUM into a multidisciplinary center of excellence tightly focused on research in the NCMHD priority areas of cardiovascular disease and diabetes. We plan to conduct three research projects aimed at generating new knowledge for improving minority health among Carribean Latinos. The first project is a randomized controlled trial (RCT) in poorly controlled Latino diabetics to examine the effectiveness of a community based Community Health Worker intervention at improving glycemic control and includes blood pressure and cholesterol as secondary outcomes. The second project is a prospective study examining the long-term consequences of poor glycemic control on cognitive function among diabetics. The third project, also an RCT, will evaluate the effectiveness of a community-based comprehensive therapeutic lifestyle intervention that includes group sessions and motivational interviewing on blood pressure control. The proposal includes an adminstrative and research core providing the requisite administrative, methodological, statistical and data management infrastructure to carry out these three thematically linked research projects. All three projects will be conducted in our local community and the Planning Council established in the 1st phase of CHUM will continue to serve as the formal venue for community input into the overall direction, shape and execution of the CHUM project. Further, both RCTs build on the community partnerships established by CHUM's Community core and include community based organizations as integral members of the research. Lastly, through CHUM's established partnerships and successful efforts at obtaining support from other sources, CHUM will continue to provide training opportunities for junior faculty, post-doctoral trainees, fellows and undergraduate students.